The kidneys are primary excretory organs that perform the retention of the electrolyte and water balance. They perform a crucial role as an endocrine organ as well. They are present from T12 to L3 vertebrae and are situated retroperitonealy in the posterior abdominal wall next to the spinal column.1

In male, a kidney typically weighs 150 gm, whereas in female it weighs 135 gm. A kidney's dimensions are 6 cm in length, 3 cm in width, and 1 cm in thickness. Each kidney is formed like a bean. The kidneys have a convex anterior surface, a flat posterior surface, a convex lateral border, a concave medial border, a broad, thick upper pole, and a pointed, thin lower pole. The left kidney is slightly longer and thinner than the right, lying closer to the median plane, whereas the right kidney is typically slightly inferior to the left, indicating its relationship with the liver.1

Because morphometric studies are thought to have a significant clinical significance in conditions such as kidney sizes being significantly influenced by micro and macrovascular diseases, congenital anomalies, systemic diseases, and neoplasia, they have attracted a lot of research attention.2

Given the close correlation between renal function and size, evaluations of renal parameters such as length, width, and thickness are critical for the diagnosis and management of renal disorders. In adulthood, fetal lobulation continues to look longer than usual.3

Anatomical studies on renal parameters are seldom missing, but there is limited data accessible in the literature on renal morphometry, which was primarily based on radiological examinations like ultrasound, CT-scan, and MRI.4,5

When viewed from anteroposterior, the renal vein, renal artery, and pelvis are arranged anatomically at the renal hilum. Although the typical structural hilar arrangement of the kidney may have variations in which renal artery and vein have its divisions outside of the hilum, and these structures from a new set of hilar arrangement.

Aims and objectives

Our primary aim is to examine the morphometry of human cadaveric kidneys and its clinical correlation

The study has been conducted on 100 human cadaveric kidney specimens (50 right and 50 left of unknown age and sex obtained from cadavers during routine dissections for undergraduate MBBS students in Madhya Pradesh population from the collection of Department of Anatomy of Index Medical College, Indore. All the specimens in the study were preserved in 10% formalin solution.The kidneys with gross pathological changes was excluded from the present study. The morphometric parameters were recorded by using digital vernier calliper and weight was done by weighing machine.

Fig.1 Parameters of gross anatomy of kidney.                                  Fig.2: Measuring Length of Kidne

                   Fig.3: Measuring width of kidney.                          Fig.4: Measuring thickness of kidney

This study presents morphometric anatomical data related to the morphometry of the kidney and the gross anatomical variations observed in the population of Madhya Pradesh, India. The investigation uncovered several important findings.

In the present study a total of 100 kidneys were examined comprising 50 right kidneys and 50 left kidneys. The weight of the right kidneys ranged between 62 to 167 gm with mean weight calculated 108.48±28.99 gm. The length of the right kidney ranged from 6.23 to 11.42 cm and mean length of 8.72±1.40 cm. The width of the right kidney at the superior pole varied between 2.74 cm and 7.78 cm with mean width of 4.93±1.44 cm. At the inferior pole the width ranged from 2.43 cm to 7.32 cm with mean width of 4.78±1.33 cm. The thickness of right kidneys at the superior pole ranged from 1.83 to 5.83 cm with mean thickness of 3.24±1.02 cm. At the inferior pole the thickness ranged from 1.67 to 5.83 cm with an average of 3.14±0.93 cm.

The weight of the 50 left kidneys ranged between 69 to 156 gm with mean weight calculated at 103.12±29.80 grams. The left kidney exhibited a length range from 6.21 cm to 10.83 cm with an average measurement of 8.50±1.31 cm. The width of the left kidney at the superior pole varied between 2.78 and 8.15 cm with an average measurement of 4.91±1.37 cm. At the inferior pole the width ranged from 2.58 to 7.93 cm and mean width of 4.71±1.35 cm. The thickness of the left kidneys at the superior pole ranged from 1.89 to 5.13 cm with an average of 3.36±1.00 cm. At the inferior pole the thickness ranged from 1.67 to 4.89 cm with an average of 3.16±0.96 cm.

When data was compared on left and right side kidneys there was no significant difference in the weight, length, thickness and width as no parameter demonstrated a pvalue>0.05 in paired t test in our study.

Table 1:morphometric parameter data of kidney

Graph:- morphometric parameter data of kidneys of right and left side. ​​

Our findings contributes to growing knowledge on kidney morphometry and provide comparison of our results with those of other studies that were carried out previously in different populations that helps us to understand the factors like ethnicity, environment and methodological techniques which can affect renal dimensions.

Mohammadi et al (2018) performed a study including an Iranian population of 1200 patients and found out that Mean weight of the kidneys was 143.03 gm which is higher than our results. Increased size of the kidneys of Iranians population might have adapted to the influences such as the increased size of the body.10 Naik et al (2014) conducted a study in Karnataka and observed that the mean kidneys weight was 86.88 gm of right kidneys and 96.32 gm of left kidneys which were lighter than the present study kidneys.24 The lowest mean weight was recorded in a study made by Roy and Pal (2022) showed that the mean kidney weights of a population from Kolkata were 85.56 gm of right kidneys and 91.49 gm of left kidneys.34 While the heaviest mean kidney weights were found in a study conducted by Deep A et al (2023) that were 155.33 gm on right side and 153.67 gm on the left side.16 The heavier weight on right side were similar to Ashwini NS et al (2017)30, Shambharkar SB et al (2020) 12  and Deep A et al (2023)16 while in contrast to present study left side kidneys were heavier in studies by Rao KEV et al (2013)31, Naik KS et al (2014)24, More s et al (2015)29, Varalakshmi KL and Sangeeta M (2017)35 and Roy S & Pal A(2022)34.

 Similar to our study Rao KEV et al (2013), Devdas D et al(2019) and Deep A et al (2023) in their study observed right kidney were longer.35,11,16 While studies including Tanaka G et al(1988)6, Sampaio FJ & Mandarim-De-Lacerda (1989)4, Emamian SA et al (1993)7, Barton EN et al (2000)8, Sahni D et al (2001)9, Okoye IJ et al (2005)36, Raza M et al (2011)2, Saeed Z et al (2012)26, Gupta S et al (2013)25, Naik KS et al (2014)24, Murlimanju BV et al (2014)37, More S et al (2015)29 , Srivastava A et al (2016)21, Ashwini NS et al (2017)30, Varalakshmi & sangeeta (2017)35, Mohiuddin M et al (2017)19, Purohit K et al (2017)17, Prasad VSA & Kumar US (2018)38, Londhe SS & Rathore PR (2018)39, Shambharkar SB et al (2020)12, Roy S & Pal A (2022)34, Saha N et al (2023)15 and Sah N et al (2023)13 found the left kidney longer than right. The longest kidneys in all studies were noted 12.66 cm on right side by Deep A et al (2023) and 12.71 cm on left side by More S et al (2015).16,,29 Study conducted in Korea by Kang et al and in Iran by Mohammadi et al shows that kidneys in these species are longer than the findings of the present study that indicate increased renal length for non Indian studies.10

In the previous studies over all width was more at superior pole than the inferior pole except Ashwini NS et al (2017) where on right side kidneys width at superior pole was 4.89 cm and at inferior pole width was 4.91 cm.30 The highest width was noted 6.62 cm by Rao KEV et al (2013) and the lowest width was 3.5 cm and 3.55 cm on superior pole in right and left kidneys respectively and 3.06 cm and 3.09 cm at inferior pole on right and left kidneys respectively observed by Varalakshmi & Sangeeta (2017) study.31,30 The kidneys of Korean population according to Kang et al (2007) were wider where mean width was 6.2 cm. Mohammadi et al.40,10 (2018) observed that average kidney size of the Iranian population in the study was 5.09 cm wider than other population average.10 This can be due to smaller body frames commonly noted in Indian subjects against Korean and Iranian populations revealed in this study may be responsible for the lesser width reported.

In Maharashtra kidney thicknesses was around 3.3 cm observed by Londhe and Rathod (2018) in the state.39 kidneys thickness measured in Korea was 4.73 cm by Kang et al (2007)40, in Odisha 4.75 cm by Purohit K et al (2017)17, in pakistan was 4.44 cm by Mohiuddin M et al (2017)19, in Tripura was 4.20 cm by Saha N et al (2023) and in uttar Pradesh was 4.12 cm by Deep et al in year 2023 were much thicker than present study. Renal thickness variations closely correlate with overall kidney size and allometric variation, and these differences may be either genetic or environmental (dietary protein intake).15,16

Moorthy et al. (2011) reported that volume of right kidney is significantly smaller than that of left kidney and possible explanation given for this was that the spleen on the left side is smaller than the liver on the right providing the space for the growth of the left kidney.41 Another explanation for the variation in the weight of kidney was given by Emamian SA et al. (1993) that the left renal artery is short and straight so increased blood flow in the left renal artery might result in increased size of left kidney.7 As vesicoureteric reflux disorders alter the renal dimensions these morphometric values will be helpful for clinicians while managing these cases.

A significant correlation between kidney size and kidney function has been observed in patients with chronic kidney disease (CKD).14 The renal dimensions might also vary among population of different geographical origin.27 Tissue masses in the kidney found incidentally are increasing with the diffusion of imaging in cuts and the treatment has considerably changed over the past years and Partial nephrectomy (PN) proves to be the standard due to its good results on the cancer and progress in surgical techniques. Renal volume assessment is an important parameter in evaluation and follows up of kidney transplant recipients, CRF and hypertension secondary to renal artery stenosis because changes in renal volume may be a sign of kidney disease. It is also useful in younger patients with vesico ureteric reflux (VUR) which alters the morphometric profile of the kidney. Barton EN et al. (2000) conducted a sonographic study of 49 randomly selected healthy adult Jamaicans to establish a guide for renal dimensions in the population. There was no difference in width between right or left kidneys in the group as a whole or within either gender alike insignificant difference of our findings.8a

All morphometric parameters on were larger on the right side than on the left side, according to the present study. The exterior of kidney morphometry of the right and left sides did not differ significantly (paired t test). The findings emphasize the need for criteria for renal dimensions fitted to a specific group to improve diagnostic accuracy and surgical outcomes. The size of the kidneys is an important factor in the diagnosis of such conditions as chronic renal disease, because all deviations from the standard showed the presence of pathology. However, the renal dimensions examined in this study lie within the expected range for Indian populations but do not agree when compared with data from other nations. These studies highlight the differences and show why region specific study is so important to the shaping of medical practice showing that it is gene, environment and lifestyle that impact on kidney morphology.

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